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Contents

1. NEWS

A first regional grant under the new funding model has been signed, bringing $100 million to the Greater Mekong sub-region for a wide-ranging initiative to avert the spread of artemisinin resistance within five malaria endemic countries.

2. NEWS

Russia is transitioning from recipient to donor of Global Fund grants, prompting concerns from civil society about potential gaps in service delivery, specifically related to prevention and harm reduction activities.

4. NEWS

With a budget of $65 million annually, Local Fund Agents (LFAs) represent a significant and critical element in the Global Fund’s architecture and reflects about 20 percent of its total operating budget. A review paper written by Frank Wafula and published by Aidspan explores the nature of the relationship between LFAs and the Fund and the lessons learned over the last 12 years.

6. COMMENTARY

Robert Bourgoing narrates his experience facilitating a meeting in Nairobi with representatives of about 30 organizations from East and Southern Africa involved in the monitoring of global health programmes.

7. NEWS

Two suppliers of mosquito nets implicated in corrupt practices in Cambodia see their suspensions lifted by the Global Fund and will be required to accede to a series of compliance conditions in order to continue as contractors.

$100 million grant signed for Southeast Asian malaria initiative

1. NEWS

6 Feb 2014

Author:

Lauren Gelfand

Regional outreach to migrants to complement service delivery in five Southeast Asian countries

A $100-million grant to avert the spread of artemisinin resistance in five malaria endemic countries in the Greater Mekong sub-region has been signed by a full complement of stakeholders, signalling the successful achievement of a first regional application under the Global Fund’s new funding model (NFM).

The Regional Artemisinin Resistance Initiative (RAI) will support purchase of long-lasting impregnated nets, malaria case detection and provision of directly observed antimalarial treatment in Cambodia, Laos, Myanmar, Thailand and Vietnam, as well as regional and national advocacy and awareness campaigns.

A disease burden and financial gap analysis led funds to be allocated as follows: 15% to the regional campaigns; 15% to Cambodia; 5% to Laos; 40% to Myanmar; 10% to Thailand; and 15% to Vietnam.

Central to the outreach component of RAI is work to reach migrant populations living and working in border areas who are normally overlooked and often marginalized. Each country has committed to complementary national campaigns targeting these populations.

Parasite resistance to artemisinin has been detected in all of the RAI countries, which has provoked concerns among malaria clinicians and researchers that a currently small problem could multiply exponentially and become a grave danger both within the region and beyond.

The risks presented by this growing resistance to artemisinin – the primary ingredient in combination therapies that have demonstrated the greatest success in treating malaria – drove the speed and deliberation with which the RAI proposal was achieved, according to RAI program manager Izaskun Gaviria.

“Artemisinin resistance is regarded as a global threat by the international community, which allowed the team to benefit from great support from key partners,” Gaviria said in an emailed response to Aidspan questions.

The split between regional behavior change and outreach activities and national-level service delivery was also a product of wide consultations with a variety of stakeholders including civil society groups, Gaviria said. It also reflects national and international priorities to coordinate with other regional initiatives on malaria funded by donors including The Bill and Melinda Gates Foundation, AusAID and DFiD.

While the ultimate goal is to contribute to the elimination of falciparum malaria in the Greater Mekong Sub region, and to prevent the emergence or spread of artemisinin resistance to new areas, incremental success for RAI will be assessed against the progress in: :

Reduction of malaria falciparum cases per country and progress towards national malaria elimination targets (up to 50% in some countries)

Ensuring high coverage with vector control and treatment interventions in designated areas and in particular among mobile/migrant populations

Elimination of oral artemisinin-based monotherapies

RAI is one of three regional early applicants under the NFM. The other two are a malaria initiative in Mesoamerica and Hispaniola, EMMIE, that will strengthen malaria surveillance in Dominican Republic, Haiti, Panama, Costa Rica, Nicaragua, Guatemala, Belize and El Salvador; and a regional HIV harm reduction initiative stewarded by the Eurasian Harm Reduction Network in Eastern Europe and Central Asia.

A total of $116 million was initially envisioned under the transition phase for these three regional initiatives.